In this feasibility study, next generation sequencing (NGS) technologies will inform an acute lymphoblastic leukemia risk classification system, which may be adapted to identify patients who might benefit from targeted therapies; such patients will be targeted to NCTN National Treatment trials or UNMCCC-sponsored trials where appropriate, through detailed genomic data analysis performed under College of American Pathologists (CAP)/CLIA conditions and in individual case discussions in a Molecular Tumor Board.